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The Relationship Between Cytokine Concentrations and Severity Scoring Index for Crimean-Congo Hemorrhagic Fever
Sevda Onuk1, Hilal Sipahioglu1, Zehra Beştepe Dursun2
1Department of Intensive Care Unit, Kayseri City Education and Research Hospital, Kayseri, TUR.
Insights
Serum levels of interleukin-10 (IL-10), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and high mobility group box-1 (HMGB1) correlate with disease severity in Crimean-Congo hemorrhagic fever (CCHF). These inflammatory markers, along with creatine phosphokinase (CPK), are significant predictors of CCHF severity.
Area of Science:
- Infectious Diseases
- Immunology
- Critical Care Medicine
Background:
- Crimean-Congo hemorrhagic fever (CCHF) is a severe tick-borne viral illness.
- Understanding the inflammatory markers associated with CCHF severity is crucial for patient management.
- Previous studies have explored various biomarkers, but a comprehensive analysis of key cytokines and HMGB1 in relation to disease severity is needed.
Purpose of the Study:
- To investigate the association between serum levels of high mobility group box-1 (HMGB1), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-1β (IL-1β), interleukin-10 (IL-10), and tumor necrosis factor alpha (TNF-α) and the clinical severity and mortality in CCHF patients.
- To determine the correlation between these inflammatory markers and the Severity Scoring Index (SSI) in CCHF patients.
- To explore the relationship between serum inflammatory markers, HMGB1, and creatine phosphokinase (CPK) levels with disease severity.
Main Methods:
- Prospective study conducted in the intensive care unit and infection ward of a tertiary hospital.
- Inclusion of adult patients (≥18 years) diagnosed with CCHF.
- Measurement of serum levels of HMGB1, IL-6, IL-8, IL-1β, IL-10, and TNF-α at the time of admission.
- Assessment of disease severity using the Severity Scoring Index (SSI) and correlation analysis with measured biomarkers and CPK levels.
Main Results:
- The study included 30 CCHF patients (83.3% male, mean age 51.6±14.35 years).
- Significant correlations were found between the SSI score and serum levels of IL-10 (moderate), IL-6 (moderate), TNF-α (moderate), and HMGB1 (weak).
- A moderate correlation was also observed between SSI and creatine phosphokinase (CPK) levels.
Conclusions:
- Serum levels of IL-10, IL-6, TNF-α, HMGB1, and CPK at admission are significantly related to the clinical severity score (SSI) in CCHF patients.
- These inflammatory markers and CPK show potential as indicators for assessing CCHF disease severity.
- Further research with larger patient cohorts and healthy control groups is recommended to validate these findings and explore therapeutic implications.
Abstract:
Background This study aimed to investigate the effects of serum high mobility group box-1 (HMGB1), interleukin (IL)-6, IL-8, IL-1β, IL-10, and tumor necrosis factor alpha (TNF-α) levels on disease severity and mortality in Crimean-Congo hemorrhagic fever (CCHF) patients. Materials and methods This study was performed prospectively in the intensive care unit (ICU) and infection ward of a tertiary hospital in the Republic of Türkiye. Patients aged 18 years and older diagnosed with CCHF were included. Results Our study included 30 patients, of whom 83.3% were male, where the mean age was 51.6±14.35 years. The most common clinical findings in patients were malaise (90%) and myalgia (63.3%). In our study, IL-1β levels were found to be 1173.6 (783.0-1823.0) pg/mL, IL-6 69.9 (56.8-133.1) pg/mL, IL-8 191.2 (152.8-516.9) pg/mL, TNF-α 129.5 (104.9-270.8), HMGB1 37.01 (29.26-75.18), and IL-10 190.1 (IQR: 147.8-387.8) pg/mL. The patients' median Severity Scoring Index (SSI) score was found to be 2.5 (1.8-5.5). There was a moderate correlation between the patients' SSI score and serum IL-6 (r=0.464, p=0.010), TNF-α (r=0.420, p=0.021), and IL-10 levels (r=0.518, p=0.003), and a weak correlation between serum HMGB1 (r=0.392, p=0.032). The correlation between SSI and creatine phosphokinase (CPK) levels (r=0.499, p=0.036) was observed to be moderate. Conclusion It was seen that IL-10, IL-6, TNF-α, HMBG-1, and CPK levels evaluated at the CCHF patients' time of admission to the clinic and SSI clinical score were found to be significantly related. It is clear that more studies with patients and groups of healthy volunteers are needed on this subject.
